Skeletal Changes and Vascular Calcifications in Chronic Kidney Disease: Two Connected Cups

Abstract In chronic kidney disease, calcium and phosphate imbalances occur, causing numerous dysfunctions of related regulatory mechanisms, called chronic kidney disease–mineral and bone disorder (CKD-MBD). Its consequences include impaired bone health and heightened risk of fractures, and extensive soft tissue calcification, most significantly affecting arteries, leading to the deterioration of cardiovascular health. Over the past decades, many pathophysiological connections have been found and many markers have been discovered that can be used to evaluate the bone status, risk of fractures, as well as the extent of vascular calcifications. These include a multitude of older and newer laboratory parameters and imaging methods. The use of effective predictive markers and related scoring systems can significantly improve the identification of patients who are most at risk of developing complications. Aside from the discoveries of novel markers, the opportunistic use of some commonly utilised diagnostic methods that the patient has already undergone for other indications can be a powerful diagnostic tool.